Intestinal obstruction is a disruption of the normal movement of food through the gastrointestinal tract. Develops as a result of obstruction of the intestinal lumen, spasm or paralysis. This is very dangerous disease, since in most cases emergency surgery is necessary. It is important to know the main signs of intestinal obstruction in children and adults in order to be able to recognize them and consult a doctor in a timely manner.
Types of intestinal obstruction
Signs of intestinal obstruction directly depend on its type. According to the mechanism of development, mechanical and dynamic forms of the disease are distinguished.
Mechanical intestinal obstruction occurs when the intestine is blocked at any level. The causes of occlusion from the inside can be foreign bodies, helminths, gallstones, scars and tumors of the intestinal wall, and from the outside - tumors and cysts.
All these options relate to obstructive mechanical obstruction. With volvulus, nodulation and strangulation of the intestine, the mesentery is compressed and strangulation obstruction develops. The intussusception type is observed with intussusception - wedging of one section of the intestine into another. In the case of compression of the intestine by adhesions, adhesive mechanical obstruction is distinguished.
Dynamic intestinal obstruction develops when intestinal motor function is impaired. This can be observed with excessive relaxation (paralytic version) or overexertion (spastic version).
Depending on the course, intestinal obstruction can be acute or chronic. According to the level of obstruction - high (in the small intestine) and low (in the large intestine). Complete and partial - depending on the degree of blockage of the intestinal lumen. By origin - congenital or acquired obstruction. The congenital variant occurs mainly in children due to developmental defects of the gastrointestinal tract. intestinal tract.
Signs of intestinal obstruction
The main symptoms of this disease:
- retention of stool and gases;
- increased gas formation and bloating;
- nausea and vomiting.
Pain is the first and constant sign of this disease. It appears suddenly, regardless of meals. It has a cramping, unbearable character. The frequency of pain is determined by intestinal peristalsis, with each wave it intensifies. The patient's face becomes distorted, and symptoms of shock may appear - pallor, cold sweat, rapid heartbeat.
By the end of the first day, the pain may decrease or stop altogether. This is an unfavorable sign, since the easing of pain in this case means necrosis and necrosis of the intestine. Within 2–3 days of imaginary well-being, peritonitis will develop, and the chances of saving the patient will become minimal even with surgery.
Since intestinal obstruction stops the movement of feces through it, stool and gas retention occurs. They accumulate in the intestine, stretching its walls and increasing pain. In this case, bloating occurs in the abdomen, and its asymmetry may be observed. In some cases, the swollen intestine and its peristalsis are visually visible through the anterior abdominal wall.
Vomit - common symptom with intestinal obstruction. Its frequency and nature are determined by the type of disease. In the first days, vomiting occurs due to a violation of the movement of contents through the gastrointestinal tract. From the intestines, contents can be thrown into the stomach. Then the vomit has the color and smell of feces. In the following days, nausea and vomiting are signs of intoxication of the body.
Signs of mechanical intestinal obstruction
Mechanical intestinal obstruction occurs in approximately 90% of all cases. The clinical picture is greatly influenced by the level of obstruction.
As the process develops in the small intestine, symptoms appear and increase quickly. Sharp pain of a cramping nature appears in the central part of the abdomen (around the navel). They are accompanied by nausea and vomiting. The higher the obturation, the more pronounced the vomiting is - indomitable, profuse, repeated.
With complete obstruction, stool retention occurs; with partial obstruction, diarrhea may occur. Characterized by increased peristaltic sounds in the abdomen, which become louder in the wake of pain. With the development of necrosis or infarction of the intestinal wall, on the contrary, there are no sounds in the abdomen. This is an unfavorable sign.
Obstruction in the large intestine takes longer to develop and its symptoms are less pronounced. First, constipation occurs, gradually giving way to a complete absence of stool and bloating. Then the pain comes and slowly intensifies. The pain can be clearly localized or spread throughout the abdomen. Vomiting does not always happen, most often once.
With intestinal volvulus, the onset and development of the disease is acute, with severe cramping pain. The process progresses quickly and requires urgent care.
In the clinical course of mechanical intestinal obstruction, several stages are distinguished:
The rate of development of symptoms depends on the specific type of mechanical intestinal obstruction. In severe cases, peritonitis develops already on the second day. Therefore, for any severe abdominal pain, you should consult a doctor without taking painkillers to prevent lubrication clinical picture.
Signs of dynamic intestinal obstruction
Dynamic intestinal obstruction is rare - about 10% of cases. With this type of disease, there is a failure in the motor function of the intestine. The peculiarity of this option is that there are no obstacles to the passage of feces in the intestine, but there is a temporary cessation of contractile movements.
The paralytic appearance most often occurs after injuries and surgical interventions in abdominal cavity as a reflex protective reaction to irritation of the nerve endings of the peritoneum. There are 3 periods in the development of this variant of intestinal obstruction:
The spastic type of intestinal obstruction is relatively rare (in case of poisoning with poisons, heavy metals, porphyria, uremia, etc.). In this case, a spasm of the muscles of the intestinal walls occurs, and peristalsis temporarily stops.
This condition can last from several minutes to several hours. The pain is sharp, so strong that it is sometimes unbearable. They do not have a clear localization; they spread throughout the entire abdomen. Retention of stool does not always occur and is transient. The general condition of the patient is satisfactory. This type intestinal obstruction has a favorable prognosis and is treated conservatively.
Chronic intestinal obstruction
Mostly found acute obstruction intestines. 
The chronic form rarely develops. The causes most often are hernias, adhesions growing in the intestinal lumen or outside the tumor.
In this case, there is a delay in the passage of stool and gases, severe pain of a spastic nature, and there may be nausea and vomiting. After some time (from several hours to 1–2 days), all symptoms disappear on their own or as a result of conservative treatment. In the first days after this, diarrhea and bloody stools often occur.
Partial intestinal obstruction
The presence of bowel movements and the passage of gases does not always indicate the absence of intestinal obstruction. With partial obstruction of the intestine, stool is passed out in scant quantities, often mixed with blood. Accompanied by pain of varying intensity and localization. The abdomen is soft but painful. This clinical picture may be a sign of a chronic form of the disease. At acute version Complete obstruction of the intestine gradually develops, and corresponding symptoms appear.
Acute abdominal pain - dangerous symptom. They may indicate various diseases abdominal organs, including such dangerous ones as intestinal obstruction. The favorable outcome directly depends on the type of disease and timely consultation with a doctor.
With the dynamic option, the prognosis is most often good, and treatment is conservative. In case of mechanical intestinal obstruction, it is almost always necessary to surgery. The patient’s likelihood of recovery depends on this. Therefore, it is very important not to hesitate if signs of intestinal obstruction appear, but to immediately consult a doctor.
Such a common symptom as abdominal pain should always be treated with caution, because it can be a manifestation of a serious surgical pathology, in which the movement of food contents through the digestive tube is disrupted. This condition can lead to severe consequences, therefore it is important to recognize it in time and promptly seek medical help.
This condition is characterized by a violation (complete or partial) of the movement of contents through the intestinal tract.
This is an acute surgical pathology that is more common in the male population aged 30-60 years. But women and children with such a diagnosis are not at all uncommon in hospitals and clinics. Among all “acute abdomen”, this diagnosis is established in 5-9% of cases.
Classify this pathology according to the anatomical principle into the colon (if the process affects the final sections of the gastrointestinal tract) and small intestine (with lesions of the duodenum, jejunum and ileum). By origin - congenital and acquired.
But more informative is the classification, which reveals the mechanism of the disease, according to which dynamic and mechanical obstruction are distinguished.
Reasons for the development of the mechanical form
This pathology is called obstructive. The term comes from Lat. obturatio - blockage.
- Pinching, twisting of intestinal loops behind each other or around their axis, the formation of nodes, which results in a disruption of the blood supply to the vessels and blocking of blood flow in the areas of the loops. This is the situation that people call “volvulus.” Medical name This phenomenon is caused by strangulation intestinal obstruction.
- Combination of obstruction and entrapment. This is a situation in which one loop is inserted and pressed into another, being both a mechanical obstacle and a source of compression of blood vessels and cessation of normal blood flow.
Reasons for the development of dynamic form
It is based on functional disorders motor activity of the gastrointestinal tract, namely:
- persistent spasm
- paresis
- paralysis
Based on the mechanism of motor disorders, this form is divided into paralytic and spastic.
Defects in muscle tone and peristalsis in the form of paralysis and paresis can be observed both throughout the intestine and in its individual sections. Provoke motor-evacuation dysfunction and cause paralytic ileus The following states are possible:
- injuries, operations on the abdominal cavity and gastrointestinal tract
- inflammatory processes: appendicitis, peritonitis, ileitis, cholecystitis
- pathological conditions occurring outside the peritoneum: myocardial infarction, spinal and skull injuries, pneumonia
- retroperitoneal hematomas, as well as thrombosis of mesenteric vessels, splenic infarctions
- metabolic diseases (diabetic precoma, cystic fibrosis)
Persistent spasm of the intestinal muscles is possible with:
- ascariasis
- hepatic and renal colic
- diseases nervous system(hysteria, neurasthenia)
- intoxication of the body both by products of internal metabolism (in case of severe renal and liver failure) and substances coming from outside (alcohol, heavy metals)
Adhesions as an etiological factor
Adhesions can deform the structure of an organ, tighten, disrupt anatomical location intestinal loops.
Some practicing surgeons distinguish separately the adhesive form of disruption of the passage of contents through the intestine, thereby emphasizing the role of the causative factor: the presence of adhesions - connective tissue fibers formed as a result of an inflammatory process or trauma to the organ.
Other authors believe that it is more convenient to consider the adhesive process not as a separate form, but as one of the causes of obstructive and strangulation obstruction, since these structures can cause both circulatory disorders and block the intestinal lumen.
Both opinions are justified and have the right to exist.
Mechanism of damage development
What is the cause of a dangerous surgical pathology is clear, but what happens inside the intestine when the normal movement of food through it stops?
In general terms, the pathogenesis can be represented as follows:
The contents in the form of food gruel encounter an obstacle on its way, and stagnation occurs. The intestinal wall is subject to excessive stretching, and excess digestive juices, bile, pancreatic secretions, and gases accumulate in it due to the activity of microorganisms and the breakdown of organic acids.
The altered wall is unable to fully carry out absorption, the pressure in it increases, the intestinal loops increase in volume, swell, change color, become purple or bluish, or are completely absent.
The pathogenesis of the process and its speed depends on the form of obstruction. In the strangulation form, due to a sharp disruption of blood circulation, pathological changes in the intestinal wall increase extremely quickly: its vessels are compressed, blood clots form, and death - necrosis - develops.
All processes lead to disruption of the functioning of a part of the intestine or its part. Through a non-functioning organ, pathogenic microorganisms, part of the liquid contents, and bacterial toxins can penetrate into the abdominal cavity. Peritonitis develops.
Such changes in the body cannot but affect the patient’s well-being. And if on initial stages the process is local, limited in nature, albeit with a clear clinical picture. Then, as the disease progresses, peritonitis develops, followed by sepsis (blood poisoning) and multiple organ failure.
On the stage systemic damage body without highly qualified medical care the disease ends in death.
Symptoms of intestinal obstruction
You can suspect a disease if you know the main signs and symptoms that are characteristic of it. Most often, patients with a confirmed diagnosis complain of:
1. Abdominal pain
The earliest, most frequent and widespread symptom. They can be characterized as cramping, increasing in intensity, like colic with “light” pain-free intervals during obstruction, or as unbearable, constant with ischemic disorders.
2. Vomiting
Occurs in more than 75% of patients. It is typical that when pathology occurs in the high small intestinal sections, vomiting is quite common, occurs repeatedly, and does not bring relief. Reflex incessant vomiting is very characteristic of the strangulation form.
Disturbances in the passage of food in the lower intestinal regions rarely cause this symptom. If vomiting occurs, then late stages disease, in advanced cases it has an unpleasant smell of feces due to the decomposition of the contents of the vomit.
3. Lack of stool, impaired passage of gases
These symptoms appear when the lumen of the organ is completely blocked, with partial obstruction, and in the early stages they may be absent.
Stool may be partially present during the emptying of sections below the site of the obstruction, but if the focus of the pathology is located in the sigmoid colon and more distally, then the patient cannot recover at all “by and large.”
4. Bloating
A characteristic sign that allows us to make an assumption about the level of obstruction. If the changes affect the high intestinal sections, bloating is uncharacteristic, since almost all the loops are in a collapsed state.
If the passage is disrupted in the lower small intestinal sections, symmetrically.
Colon pathology is characterized by asymmetry: the right half of the abdomen may be enlarged, corresponding to damage to the right colon, or the left half, where the opposite sections are located.
Sometimes, with obvious obstruction, peristaltic waves and swelling of the loops can be visually observed. Paralytic processes are characterized by a symmetrical accumulation of gases without distortions of the abdomen in any part of it.
5. Peristaltic noises
Rumbling, gurgling, transfusion - these signs actively appear in the first stages of the disease, and indicate disturbances in motility and gastrointestinal function.
In the later stages, with the development of necrosis and peritonitis, all noises subside. This is a prognostically unfavorable sign; “deathly silence” indicates irreversible changes in the organ.
Stages of the disease
There are three successively replacing stages of obstruction, each of which corresponds to certain manifestations.
Knowing the features of the clinical picture step by step, the doctor can quickly navigate, determine exactly how much medical care the patient needs, guess from the clinic how long the disease lasts and what condition the intestines are in.
Stage 1 – early
Lasts up to 12 hours. The main complaint of patients is pain. In case of a mechanical obstruction in the gastrointestinal tract - cramping, with light intervals; in case of circulatory disorders - unbearable, extremely pronounced (sometimes of such intensity that it can provoke a painful shock)
Stage 2 – intermediate
From 12 to 24 hours. The clinic is accompanied by vomiting and bloating. Repeated profuse vomiting leads to dehydration and thirst.
After drinking liquid, the patient feels a deterioration in health: increased pain or re-vomiting. The condition progressively worsens from moderate to severe.
The patient is agitated, takes a forced position or cannot find a position that would alleviate his condition, and rushes around the bed. Pulse is frequent, weak filling, tachycardia, skin pale, cold.
When examined by a surgeon, specific symptoms are revealed: the sound of splashing, falling drops, Valya, Kivulya, which will reliably indicate to the surgeon that there is an obstruction.
Stage 3 – late
At this stage, the patient’s condition is assessed as extremely serious, consistent with the clinical picture of peritonitis.
There is an increase in body temperature, pulse, respiratory rate, and tests show signs of severe inflammation.
There are no bowel sounds. The body refuses to work, decompensation and multiple organ failure sets in.
Without treatment, the patient at this stage has no chance of survival.
How to diagnose pathology
In recognizing pathology important role The qualifications of the surgeon, his ability to correctly conduct an examination, palpate the abdomen, collect anamnesis, quickly find his bearings and decide on the tactics of managing the patient play a role.
This diagnosis does not tolerate slowness and does not allow long thinking and waiting. At maximum short time If obstruction is suspected, the patient should undergo the following diagnostic tests:
- X-ray examination of the abdomen vertical position and horizontal position on the left side. Radiography can be performed with barium suspension contrast.
The diagnosis will be confirmed by visualized accumulations of gas in the small intestine (normally there is gas only in the colon), “inverted bowls” - gas above the liquid level, “organ pipes” - swollen loops with gas and liquid. This is how radiologists describe confirmed intestinal obstruction.
- colonoscopy
- irrigoscopy
These methods are used to clarify pathology in the final sections of the gastrointestinal tract; they will help identify mechanical cause closing the lumen, more accurately determine the localization of the process.
- laparoscopy
It is used more and more often in modern surgery. Through small incisions on the anterior abdominal wall, the doctor inserts an endoscopic device with a camera into the abdominal cavity; on the monitor screen, which is connected to the endoscope, organs and pathological changes are visualized with high accuracy.
In addition to diagnostic, the method can be used with therapeutic purpose: laparoscopically it is possible to perform some manipulations to cut adhesions, remove foreign bodies, and perform detorsion.
- Ultrasound of OBP (due to increased accumulation of gases, it may be difficult to perform)
Both methods are very informative in determining fluid in the abdominal cavity, tumors, and infiltrates.
Treatment of intestinal obstruction
All patients with a suspected diagnosis should be urgently hospitalized in a surgical hospital.
After a thorough survey, examination, and diagnosis, the doctor determines the type of obstruction and, taking into account the patient’s condition, chooses a treatment strategy.
Patients with an established diagnosis are subject to urgent surgical intervention if:
- signs of peritonitis
- strangulation form of the disease
Surgical intervention for this form is necessary, since developing blood flow disturbances and ischemia very quickly lead to necrosis and necrosis of the organ wall.
- severe obstructive form
- severe intoxication syndrome
- in a state of shock
For other forms of obstruction (paralytic, spastic), if the patient’s condition is stable, therapy begins with conservative methods. In more than half of the cases, such methods are effective and allow one to avoid surgery.
Such methods include:
- Cleansing or siphon enema.
- Removing the contents of the gastrointestinal tract through continuous aspiration - suction with a special device that is inserted through the pharynx and esophagus. This is necessary to unload and reduce pressure inside the hollow organ.
- Novocaine blockade in the lumbar region on both sides. Allows pain relief.
- Colonoscopy when the process is localized in the distal parts. This method allows, in some cases, to eliminate sigmoid torsion, as well as endoscopically install a small stent - a metal frame that expands the wall from the inside and eliminates the phenomenon of stagnation, and removes a mechanical obstacle in the form of a foreign body.
- Drug treatment. Intravenous administration of antispasmodics, non-narcotic analgesics, ganglion blockers, anticholinesterase substances. With the help of drip infusions, the water and electrolyte balance is corrected and intoxication is combated.
Important rule: If the surgeon’s choice (for certain indications) is on conservative therapy, but after 2 hours from its start the patient does not feel relief, there is no positive dynamics, or the condition worsens, it is necessary to change the treatment tactics in favor of surgery.
Surgical treatment
Before the operation, the patient must be prepared in a short time, which includes catheterization Bladder, introduction into a vein of saline, plasma-substituting solutions. This preparation is aimed at stabilizing the patient's vital functions so that he can tolerate surgery well.
Depending on the cause that caused the obstruction, the surgeon performs one or another action aimed at eliminating it. This can be resection - removal of part of the intestine due to developed necrosis or due to tumor damage, straightening of loops, twists or nodes, dissection from rations.
Sometimes situations in the abdominal cavity are so serious that it is difficult to manage with one operation. In such cases, interventions are performed delayed, in two or three stages.
Any operations are aimed at preserving the organ as much as possible, but if the doctor sees that the intestine is not viable (it is gray in color, does not peristalt, the vessels do not pulsate), it is removed.
Any interventions on the intestines are quite traumatic and require careful monitoring and observation in the postoperative period.
Patency restored - what next?
If the cause of the disease has been managed surgically, it is very important to stabilize the patient’s condition and return him to normal life as quickly as possible through proper management of the postoperative period.
This period includes:
- getting rid of toxins and breakdown products
Infusion drugs, saline solutions, and blood plasma analogues are prescribed. Forced diuresis can be used: the prescription of large volumes of plasma replacement drugs, and then a diuretic drug that stimulates diuresis. Increased urine output “flushes” all toxins from the body.
- prevention of possible infection
Prescription of antibiotics is mandatory wide range actions intravenously, as well as through drainage tubes in postoperative wound if necessary.
- prevention of thromboembolism and thrombosis
It is necessary to tightly bandage the lower extremities and prescribe aspirin, warfarin or heparin, which have a thinning effect on the blood. It is important not to let the patient “lie down”: perform verticalization as early as possible.
- normalization of intestinal function
For several weeks, they continue to aspirate the contents of the gastrointestinal tract through a probe, administer prokinetics that stimulate motor skills, and prescribe sessions of physiotherapeutic procedures with electrical stimulation.
Success in the treatment of this pathology depends on timely diagnosis, so you should listen to your body. If it gives signals of trouble in the form of abdominal pain, bloating or vomiting, you should not self-medicate, it is better to consult a specialist as soon as possible!
is a syndrome that occurs against the background of complete/partial disturbances in the motor activity of an organ or mechanical blockage (obstruction) in one of its sections, creating difficulty for the further movement of food. Many diseases lead to this complication. Intestinal obstruction is a serious problem that leads to changes in metabolic processes, poisoning of the body. Treatment is carried out under the supervision of a doctor in a hospital.
Classification
Since a set of symptoms associated with impaired peristalsis can be a consequence of a whole list of diseases, there are many types, forms, and types of this syndrome.
Depending on the genetic reasons distinguish between congenital and acquired intestinal obstruction. The pathological process occurs in acute or chronic form. The disorder extends completely to the entire organ or a separate part of it.
The cause-and-effect relationship, as well as the features of the course, are the basis of the classification. Based on these characteristics, mechanical, vascular, etc. are distinguished. Each of them has its own subspecies.
Mechanical
This form is associated with the appearance of some obstacle. The closure of the area occurs gradually or suddenly. Mechanical intestinal obstruction can occur due to:
Food moves through the gastrointestinal tract using contractile movements of a certain strength and frequency.
This mechanism is disrupted when the muscle layer of the organ for some reason fails to cope with its functions.
Peristalsis slows down greatly or stops completely. In the dynamic form of the pathology, obstruction and strangulation of the intestinal mesentery are not detected.
Based on the cause that caused the condition, there are 2 types of syndrome: Intestinal obstruction in this case is caused by cessation of blood flow in the mesenteric arteries. This condition is associated with the formation of blood clots, embs (clogging particles). After 2-3 hours, intestinal motor function fades, and gangrene begins. Tissue death due to vascular obstruction is a complication of diseases circulatory system
, hearts.
According to the level of the pathological process, high and low obstruction are distinguished. This classification assumes the anatomical location of the obstacle to the movement of food. Obstruction small intestine corresponds high level . The obstacle in this type of pathology is located away from the muscle connecting the duodenum to the diaphragm. The anatomical border that conventionally separates the upper and lower obstruction is the Bauhinian valve. It connects the small and large intestines. High obstruction
occurs in most cases.
The length of the small intestine is about 5 meters. The loops of the organ are fixed on the abdominal wall by two-leaf ligaments - the mesentery.
Obstructions located below the connecting valve are referred to as colonic obstruction. It is diagnosed in 20-30% of cases.
Causes People with or acquired disorders are susceptible to intestinal obstruction.
- The main factors provoking mechanical blockage of loops:
- elongation, excessive mobility of the organ;
- narrowing of the lumen;
- additional depressions and folds in the inner walls of the abdomen;
- adhesions – adhesive seals made of connective tissue, which most often occur after surgical interventions;
- hernias - protrusions;
- polyps;
- tumors;
- cysts;
- fecal, gallstones;
Other types of intestinal obstruction are often associated with nutritional (dietary) characteristics. The extinction of peristalsis is observed after consuming high-calorie foods in large volumes, a large meal after a long fast, or a mono-diet.
In children, the cessation of physical activity is often associated with the transition to formula, rickets.
Symptoms
The first signs of the disorder in adults are cramping pain in the pit of the stomach, near the navel. The attack begins suddenly. The pain may subside temporarily or be permanent, depending on the cause. Usually attacks are repeated at intervals of 10-15 minutes. The pain intensifies during the peristaltic wave. Without treatment, they go away within 2-3 days from the first episode. This warning sign, indicating complete cessation of motor function.
Obstruction associated with intestinal paralysis is characterized by dull arching pain. A person does not feel any overflows or noises in the abdominal cavity that indicate the digestive process.
Characteristic symptoms by which intestinal obstruction is recognized:
- external asymmetry;
- swollen abdomen with visible peristalsis;
- vomiting is combined with stool retention.
The patient has visible bulges on the sides or anterior wall of the peritoneum. This sign is used to determine acute intestinal blockage. Severe bloating is associated with expansion of intestinal loops. The increase occurs due to stool retention, gases, and fluid accumulation. With intestinal obstruction, pain occurs as a result of damage to nerve endings. Against the background of obstruction and extinction of peristalsis, the receptors are pinched and their integrity is disrupted.
Small intestinal obstruction at an early stage does not manifest itself as stool retention. The contents of the lower sections are promoted. There may even be multiple stools during therapeutic procedures. Defecation is not difficult.
Stool retention is a characteristic manifestation of an obstruction in the large intestine. The mechanism of development of this symptom depends on the cause of the disorder. The obstacle is a foreign body, decreased motor activity, and lack of blood supply.
Symptoms of intestinal obstruction associated with intoxication of the body:
- nausea;
- weakness;
- headache;
- cardiopalmus;
- low pressure;
- dyspnea;
- dry mouth.
Such signs appear as a result of gradual poisoning of the body.
When the obstacle is located high, vomiting is repeated. It does not alleviate the patient's condition. Vomit contains food debris, then bile. After some time, the separated masses acquire Brown color, putrid smell.
Colon obstruction is characterized by vomiting 1-2 times.
If the patient is not provided with medical assistance in a timely manner, peritonitis develops - inflammation of the peritoneum.
The chronic form of intestinal obstruction appears due to adhesions and tumor growth. Most often, a sluggish process is observed after surgery on the gastrointestinal tract. The chronic form is manifested by stool disturbances (diarrhea alternating with constipation), increased gas formation. When the tumor grows to a certain size or the adhesions completely block the intestinal loop, the process becomes acute form obstruction. In this case, the pathology develops rapidly and requires emergency care.
Stages
Acute intestinal obstruction (AIO) goes through several stages until the complete cessation of motor activity. Process stages:
- The initial phase of the “ileus cry”. It lasts 12-16 hours. Attacks of very severe pain sometimes lead to shock and confusion. Periods of peristaltic waves alternate with calm.
- Intoxication phase. Duration – 1-2 days. The pain changes character - it becomes constant, without periods of calm. At this stage, a person feels bloated, an accumulation of gases. You can notice the asymmetry of the abdominal walls. A splashing noise is heard in the stomach.
- Terminal (last) stage. It occurs 36 hours after the first symptoms of intestinal obstruction. This period is characterized by pronounced malfunctions of all body systems. There is no peristalsis, peritonitis develops. The tongue is covered with a brown coating.
What not to do before the doctor arrives
If you suspect an acute attack of intestinal obstruction, you should call ambulance. Folk remedies, medications should not be taken without consulting a specialist, since this pathology has a high risk of irreversible complications.
Laxatives help only with dynamic intestinal obstruction. A patient cannot determine the type of pathology without the help of a specialist, so it is not worth the risk. Taking laxatives may distort the clinical picture. It will be more difficult for the doctor to make a diagnosis.
An enema helps remove an obstruction in the colon if it is a mechanical obstruction. However, such a remedy will be harmful if the condition is caused by pinched loops, hernia, or vascular problems.
If you suspect intestinal obstruction, you should not give an enema or take laxatives. These remedies will only make the situation worse.
Diagnostics
The initial task of the surgeon is to distinguish intestinal obstruction from diseases with similar symptoms. To do this, differential diagnosis is carried out with appendicitis, organ perforation, peritonitis, afferent loop syndrome, pleurisy, renal colic, heart disease, pancreatitis, cholecystitis.
To recognize intestinal obstruction, the doctor analyzes the patient’s complaints and conducts an external examination of the abdomen. By palpation and tapping, the most painful areas and the presence of volumetric compactions are identified. To analyze noises inside the abdomen, specialists use a phonendoscope, a special device that helps evaluate peristaltic sounds.
Instrumental examination of the abdominal cavity includes:
- X-ray. Using this method, you can see the accumulation of gases and transverse levels of liquid in the loops of the organ. This information is recorded on the x-ray. To detect a blockage and determine its location, a person is given a contrast agent to drink. This method is called the “half-glass Schwartz test.”
- Tube enterography. The survey is carried out to document the area where there is an obstacle.
- Colonoscopy. The method allows you to assess the condition of the colon. Sometimes a colonoscopy can clear the blockage.
- Ultrasound diagnostics. The study helps to distinguish intestinal obstruction from other pathologies, detect tumors, and inflammatory formations.
To make a diagnosis, women may need a gynecological examination and pelvic ultrasound. Such measures are necessary to exclude ectopic pregnancy, diseases of the genital organs.
Treatment
Intestinal obstruction - dangerous syndrome, which in prolonged cases ends in death or serious complications. Treatment should not be carried out at home without the consent of a doctor. Independent measures often turn out to be not only useless, but also dangerous for humans.
The pathology is treated by a surgeon. Only 40% of patients admitted to the department can eliminate intestinal obstruction without surgery.
Depending on the localization of the process at the first stage conservative treatment in adults includes measures:
- Removing contents from the digestive tract. Residues are evacuated using an endoscope or nasogastric tube. This measure is used in the treatment of small intestinal obstruction. To cleanse the lower parts of the organ, a siphon enema is used. Washing is carried out using a special tube. Cleansing methods are used to unload the gastrointestinal tract, reduce intra-abdominal pressure, and neutralize toxins.
- Drug treatment. In case of intestinal obstruction, the patient is intravenously administered drugs for detoxification - Poliglyukin, Refortan, etc. In addition to these drugs, protein droppers for parenteral nutrition and electrolytes may be prescribed. They help restore blood circulation, reduce the manifestations of toxicosis, and normalize the water-salt balance. Used for pain relief novocaine blockades, Papaverine, Atropine. These drugs normalize intestinal motor function. Since pathogenic microbes begin to actively multiply when the intestinal loops are blocked, antibiotics are prescribed to prevent necrosis.
The choice of treatment for acute organ obstruction depends on the cause of the disorder.
If the blockage occurs due to heavy metal poisoning, the patient is given an antidote. When the condition is caused by a lack of microelements (potassium, calcium), injections of anticonvulsants are performed. Heparin and thrombolytics help get rid of the vascular form of the pathology.
For any form of the syndrome, the effectiveness of initial treatment is assessed general condition person. When it is not possible to achieve improvement within 3-4 hours after admission to the hospital, the patient is prepared for surgery. If the diagnostic results reveal free fluid in the peritoneum, surgical treatment cannot be avoided.
Emergency intervention is carried out for peritonitis, strangulation (tightening of the walls of the organ due to mechanical obstacles). Intestinal obstruction with such features can only be treated surgically.
During surgical intervention the non-viable part of the organ is removed, the obstruction is removed, and relapse is prevented. The resection method is chosen based on the cause of intestinal disorders.
If there is delay or improper treatment, the patient may develop necrosis, perforation, sepsis, peritonitis, and internal bleeding. The prognosis is favorable if the patient seeks medical help immediately after the onset of discomfort.
The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!
Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Study Group Expert inflammatory diseases. Author of more than 300 scientific papers.
What to do if you have intestinal obstruction?
The symptoms of this disease are often mistaken for signs of other diseases of the gastrointestinal tract and attempts are made to cope with them on their own. This is absolutely impossible to do, since only timely medical care can save the patient’s life. This disease can only be treated in an inpatient surgical department.
What it is?
Intestinal obstruction consists of a partial or complete cessation of the movement of contents (chyme) through the intestines. It requires urgent medical intervention as it is a life-threatening condition.
Causes
Predisposing factors for mechanical intestinal obstruction:
- adhesions in the abdominal cavity,
- elongation sigmoid colon in old age,
- congenital dolichosigma
- mobile cecum,
- additional pockets and folds of the peritoneum,
- hernias of the anterior abdominal wall and internal hernias.
The causes can be benign and malignant tumors various departments intestines, leading to obstructive obstruction. Obstruction can also occur due to compression of the intestinal tube by an external tumor emanating from neighboring organs, as well as narrowing of the intestinal lumen as a result of perifocal, tumor or inflammatory infiltration. With a defeat of three to five lymph nodes intestinal mesentery and tumor genesis of intestinal obstruction, the cure rate is 99 percent. Exophytic tumors (or polyps) of the small intestine, as well as Meckel's diverticulum, can cause intussusception.
For other types of obstruction, provoking factors are often changes in intestinal motility associated with changes in diet:
- eating large amounts of high-calorie foods
- heavy food intake against the background of prolonged fasting (possible volvulus of the small intestine);
- transition from breastfeeding to artificial feeding in children of the first year of life.
Paralytic obstruction most often occurs as a result of trauma (including operating room), metabolic disorders (hypokalemia), and peritonitis.
All spicy surgical diseases abdominal organs, which can potentially lead to peritonitis, occur with symptoms of intestinal paresis. A decrease in peristaltic activity of the gastrointestinal tract is noted when physical activity(bed rest) and as a result of long-term intractable biliary or renal colic.
Spastic intestinal obstruction is caused by lesions of the brain or spinal cord (metastases malignant tumors, tabes dorsalis, etc.), salt poisoning heavy metals(for example, lead), hysteria.
Signs of acute intestinal obstruction
Acute intestinal obstruction is an extremely dangerous condition in which the normal passage of gastrointestinal contents is disrupted. The symptoms of acute obstruction are quite similar to partial ones. However, it occurs more quickly, aggressively and pronouncedly.
- severe abdominal pain that occurs regardless of meal time;
- nausea;
- severe vomiting (the stronger the level of obstruction, the more severe the vomiting);
- bloating;
- no gas emissions;
- bowel disorder.
If such a condition occurs, you must immediately contact an ambulance. Precious wasted time can determine a far from favorable prognosis for treatment.
Symptoms
If you suspect intestinal obstruction, it is important to know that such a disease has symptoms that develop in 3 periods:
- Early period, first 12 hours (or less). There is bloating and a feeling of heaviness in the stomach, nausea. Then pain occurs, the nature and intensity of which depend on the cause of the pathology. If the intestine is compressed from the outside, for example, if adhesive intestinal obstruction is diagnosed, then the pain symptoms are constant, but their intensity changes: from moderate to strong, leading to a state of shock. When the lumen is blocked from the inside, they are paroxysmal, last several minutes, and then disappear. Vomiting occurs when the passage of food from the stomach to the intestines is impaired.
- Intermediate period, from 12 to 24 hours. Symptoms of intestinal obstruction become severe. Regardless of the cause of the disease, the pain is constant, the bloating increases, and vomiting is frequent and profuse. Dehydration and intestinal edema develop.
- Late period, from 24 hours. Signs of intestinal obstruction in adults and children at this stage indicate the involvement of the whole organism in the pathological process. The respiratory rate increases, the temperature increases due to bacterial intoxication, urine production stops, and abdominal pain intensifies. Peritonitis and sepsis may develop.
How intestinal obstruction manifests itself depends in part on where it is located. Yes, vomiting early period The disease is typical for pathology in the small intestine, especially in its upper sections, and constipation and impaired gas discharge - in the large intestine. But in late period When peritonitis develops, these symptoms develop with any type of obstruction.
Diagnostics
To make a diagnosis of intestinal obstruction, a number of laboratory and instrumental studies are required:
- a biochemical blood test may indicate metabolic disorders (impaired composition of microelements, decreased protein);
- general blood test - there may be an increase in leukocytes during inflammatory processes;
- colonoscopy (examination of the large intestine using a sensor with a video camera at the end) helps with colonic obstruction; irrigoscopy is used to examine the small intestine;
- X-ray examination of the intestine is mandatory when making this diagnosis. By introducing a radiopaque substance into the intestinal lumen, the level of development of intestinal obstruction can be determined;
- Ultrasound examination is not always informative, since with intestinal obstruction, air accumulates in the abdomen, which interferes with the normal assessment of the data.
In difficult cases, a laparoscopic examination of the abdominal cavity is performed, in which a sensor with a video camera is inserted into the abdominal cavity through a small puncture. This procedure allows you to examine the abdominal organs and make an accurate diagnosis, and in some cases immediately carry out treatment (volvulus, adhesions).
It is necessary to differentiate intestinal obstruction from:
- acute appendicitis (ultrasound, localized in the right iliac region);
- perforated ulcers of the stomach and duodenum (FGDS, radiography with a contrast agent);
- renal colic (ultrasound, urography).
To clarify the diagnosis, it is always necessary to carry out additional methods research, since it is impossible to differentiate intestinal obstruction by symptoms alone.
Consequences of intestinal obstruction
This disease, if left untreated, leads to a host of serious complications. Thus, turning off part of the intestine, which becomes dead due to a disruption in its blood supply, provokes a disruption in its digestion and absorption of nutrients.
Decline protective functions mucous membrane leads to an increase in the permeability of the intestinal wall for bacteria and their waste products - severe intoxication occurs, and subsequently bacterial complications: peritonitis, sepsis, multiple organ failure. The cessation of absorption in the dead intestine also applies to water. Insufficient intake into the blood, coupled with frequent vomiting, leads to rapid dehydration of the body.
All these phenomena develop relatively quickly and lead to inevitable death within a few days if the patient is not promptly transported to a surgical hospital.
Treatment of intestinal obstruction
Treatment of acute intestinal obstruction begins with conservative measures. Regardless of the cause of this condition, all patients are shown hunger and rest. A nasogastric tube is passed through the nose into the stomach. It is necessary to empty the stomach, which helps stop vomiting. They're starting intravenous administration solutions and medicines(antispasmodics, analgesics and antiemetics).
Stimulation of intestinal motility is carried out by subcutaneous administration of proserin. If a hernia is strangulated, it is necessary to perform an emergency operation - to relieve intestinal obstruction in such a situation without surgical intervention impossible. In other cases, if conservative treatment is ineffective, surgical intervention is also necessary.
Before surgery, elastic bandaging of the lower extremities is necessary to prevent thrombus formation in the veins of the legs.
Surgery for intestinal obstruction is performed under general anesthesia (intubation endotracheal anesthesia with muscle relaxants). For this pathology, it is necessary to perform a wide median laparotomy - a median incision on the anterior abdominal wall. Such an incision is necessary for an adequate examination of the abdominal organs and search for the disease that caused intestinal obstruction. Depending on the established cause, appropriate surgical treatment is performed.
Nutrition
After treatment of any form of intestinal obstruction, it is necessary to strictly monitor nutrition and adhere to a diet.
In case of intestinal obstruction, products that promote flatulence and constipation are strictly prohibited:
- smoked, salted, hot, spicy foods;
- soda, coffee, alcohol;
- sweets and chocolate;
- fatty meat, fish;
- cereals that are difficult to digest (millet, pearl barley);
- legumes, mushrooms;
- fresh bread and pastries;
- white cabbage;
- apples;
- kefir, sour cream, cheese, cream, milk.
In the first month after surgery, eat pureed food. The following products are allowed:
- vegetables after heat treatment that do not cause bloating;
- fruits that do not cause bloating, ground or baked;
- low-fat cottage cheese, acidophilus;
- cereals (semolina, buckwheat, rice, oatmeal);
- lean meats and fish;
- compotes and jelly from fruits and berries.
As with any intestinal disease, with CI it is recommended to eat often and in small portions. This reduces the load on the gastrointestinal tract, regulates the secretion of gastric juices and bile acids, facilitates the work of the small and large intestines. Avoid eating foods that are too hot or too cold. Also, avoid eating rough foods that are difficult to digest. Minimize your salt intake. Drink plenty of water.
Prognosis and prevention
A favorable prognosis for the treatment of intestinal obstruction depends on the timeliness of medical care. You can’t delay seeing a doctor, otherwise if you develop severe complications great risk fatal outcome. An unfavorable outcome may occur with late diagnosis, in weakened and elderly patients, in the presence of inoperable malignant tumors. If adhesions occur in the abdominal cavity, relapses of intestinal obstruction are possible.
TO preventive measures prevention of intestinal obstruction includes timely detection and removal of intestinal tumors, treatment helminthic infestations, prevention of adhesions and abdominal injuries, proper nutrition.
Intestinal obstruction is a syndrome that causes disruption of the passage of food bolus or feces through the tract. Its always severe course and high percentage of deaths make it dangerous, so every person should be able to identify the first signs of the disease.
Symptoms
The syndrome begins with sudden pain, severe and unbearable, similar to labor pains. The patient, trying to find a position that can alleviate the condition, tries to squat or bend, touching his knees with his elbows.
Symptoms of intestinal obstruction develop very quickly: by the end of the first day, the pain puts the person into a state of shock, the skin becomes pale, the heartbeat quickens, and cold sensations appear. sticky sweat, a “ileus groan” escapes from the mouth. Then vomiting appears. Based on its contents, the doctor can determine where the “congestion” has occurred. The higher it is, the stronger the urge. Eversion of the stomach contents does not bring obvious relief.
Frequent vomiting causes dehydration of the body, peristalsis does not work, putrefactive processes produce a large amount of toxins. Increasing intoxication makes the blood thick, and leukocytosis develops against this background. Gases accumulate in the affected area, the abdomen increases in size, and the contour of a highly swollen intestine is clearly visible through the abdominal wall. If you shake it with your hands, you will hear a noise reminiscent of splashing water. It is created by digestive juice accumulated in the intestine.
On the second day after the onset of illness, other signs of intestinal obstruction appear: the patient stops excreting urine, the body temperature rises (it indicates an increase in the amount of toxins), breathing quickens, peritonitis or sepsis develops, the patient’s condition becomes critical. In the absence of treatment in within three days, death occurs. That is why it is so important to deliver the patient to a surgical hospital as early as possible.
Causes of the disease
The following factors can provoke a delay or complete absence of passage of the contents of the digestive tract:
Treatment tactics are developed taking into account the causes of obstruction, as well as the specifics of the clinical picture.
Types and features
Depending on where the “congestion” of the food bolus or feces formed, two forms of the disease are distinguished: upper (obstruction of the small intestine) and lower (obstruction in the large intestine).
Sharp cramping pains that occur in the upper half of the abdomen help to recognize a dangerous disease of the small intestine. They appear immediately, within two hours after the formation of a “congestion”, at the same time vomiting occurs, in its masses you can see the remains of undigested food of an unpleasant yellow-green color.
The second form develops more slowly, it is associated with the failure of already formed feces to pass through, and is preceded by protracted periods of constipation.
There is pain, but it is not pronounced and is localized in the lower abdomen. Nausea appears 10 hours after the formation of intestinal obstruction. It causes vomiting, its mass has a gray or brown color and fetid odor.
Based on the characteristics of the clinical picture, three types of the course of the disease are distinguished. Classification helps differentiate the pathology from others that have similar symptoms.
Acute obstruction
It occurs in three stages. In phase I, a rapid disruption of intestinal passage occurs. Within the first two hours appears strong pain And local symptoms from the stomach. After 10 hours, intoxication of the body begins, and a period of apparent well-being begins. The patient feels better, but the disease progresses.
The peritoneum swells, becomes asymmetrical, peristalsis weakens or stops altogether, sounds and signs of dehydration appear. After three days, if left untreated, symptoms begin to appear. functional disorders hemodynamics, peritonitis develops.
The phases of the course of OKN are conditional, but it is precisely this chain of conditions that makes it possible to make an accurate diagnosis. Examination of the patient makes it possible to identify increased bowel sounds, tympanitis and dullness, protective tension of the abdominal wall, pronounced asymmetry and respiratory involvement.
Partial
This is a syndrome in which there is a slow movement of stool. Its appearance in children is associated with a violation of dynamic contractions of the intestinal walls, provoked by spasm or paralysis of smooth muscles.
In elderly people, stool retention or incomplete obturation can be caused by weakening of the abdominal wall muscles, diverticula, polyps, the presence of a fecal blockage or a ball of worms. Such provocateurs consolidate the effect and aggravate the severity of the condition.
Partial obstruction appears characteristic symptoms: bloated stomach, iridescent pain, constant nausea and vomiting. There is stool, but it is rare.
Chronic
It is diagnosed when there is a violation of the excretion of the contents of the intestinal tract, which is accompanied by prolonged constipation, followed by diarrhea. This phenomenon is associated with an increase in the activity of processes leading to fermentation and rot in places where feces “stand up” and do not move.
Blockage of the intestines provokes cramping pain. It occurs at the moment of a wave of contraction of the walls of the tract; relief occurs between peristalsis intervals. Another characteristic feature chronic course of the disease - the presence false urges to defecation. The accumulation of gases leads to bloating.
If stool becomes stuck in small intestine, the peritoneum is symmetrical, with colonic obstruction it swells asymmetrically. There are several reasons that can provoke such processes: adhesions, scar strictures, tumors inside the lumen, oncology of neighboring organs (in women, the uterus, in men, the prostate).
Treatment of the disease
Since tract obstruction is a severe form of complications of various pathologies, there is no single therapeutic regimen. But formulated general principles, taking into account which they are built therapeutic measures. They are as follows.
All patients with suspected blockage of the intestinal tract should be immediately hospitalized. It is the timing of admission of such patients to the surgical hospital that determines the prognosis and outcome of the disease. The later a person enters a medical facility, the higher the risk of death.
When diagnosing dynamic obstruction, conservative treatment is used, which is aimed at restoring peristalsis and increasing the tone of the muscle layer. The basis of therapy is medications and diet.
Drugs
To restore motor function, the following are prescribed:
- Neuroleptics that inhibit the functioning of the central nervous system (Aminazin).
- Anticholinesterase drugs that activate peristalsis (“Prozerin” or “Ubretide”).
In order to achieve what you need therapeutic effect, it is important to follow the sequence of taking medications: first, drugs of the first group are administered intravenously, then, after 40 minutes, the second. Half an hour later, a cleansing enema is prescribed. To consolidate the results, electrical stimulation of the intestine is performed.
In addition, patients have their stomach and all parts of the tract washed daily. Thus, stagnant contents are removed. For this, three-meter probes with inflatable cuffs are used. In parallel with the main course, measures are taken to eliminate the symptoms of intoxication, relieve pain, and restore water-salt metabolism.
Diet
A restrictive nutrition plan is developed in each specific case, taking into account the severity of the patient’s condition and the characteristics of the clinical picture of the disease. The main task is to facilitate the work of the intestines and restore its functions.
There are general rules, they relate to the organization of the diet.
- A person must eat regularly.
- It is important to divide the number of doses into five parts, the size of each portion being “the size of a fist.”
- Overeating can trigger an exacerbation of symptoms.
- The menu should not contain products that promote gas formation or fatty foods.
- Preference is given to liquid soups and delicacies that have a slimy consistency (jelly).
When acute obstruction occurs, an adult or a child himself refuses to eat, and a zero (surgical) diet is prescribed to maintain his strength. It helps to minimize the appearance of putrefactive processes and eliminates the possibility of irritation of the tract mucosa. The main emphasis is on replenishing the water-salt balance. Allowed are diluted freshly squeezed juices, decoctions of rose hips and currants, tea, boiled cereals not made with milk, dietary meat, steamed lean fish, and white bread crackers.
Operation
All types of obstruction and strangulation (volvulus, nodulation, pinching, compression of blood vessels, mesenteric nerves), any other forms complicated by peritonitis, are subject only to surgical treatment. During this procedure, a technique is selected to eliminate the cause of the disease. X-ray or colonoscopy, rectal examination in men and vaginal examination in women can suggest a way to solve the problem, lab tests urine, blood, pathological discharge.
In the acute phase, any surgical intervention is preceded by a period of express preparation; during this time, the patient’s condition is carefully monitored; an experienced surgeon, by examining the abdomen, can independently diagnose preliminary diagnosis, and, based on it, draw up an operation plan.
After surgery, intensive therapy is carried out: the patient is given blood substitutes and saline solutions using droppers, anti-inflammatory treatment is provided, and drug stimulation of the motor function of the tract is provided. On the first day, fasting is indicated, then feeding with tubes and saline solutions, after which the patient is transferred to a zero diet.
ethnoscience
Tract obstruction is a disease in which self-medication is unacceptable. Even partial congestion can cause dangerous complications. Therefore, “grandmother’s” recipes should be taken extremely carefully and only after consulting a doctor.
Official medicine actively uses some means in the fight against chronic pathologies. Sea buckthorn juice is especially helpful. It has anti-inflammatory and laxative effects. To prepare, take a kilogram of berries, crush them in a convenient container, mix and squeeze out the juice using gauze. Take 100 grams daily, once, half an hour before meals.
Dried fruits can boast a mild laxative effect that can improve the passage of stool. To prepare the medicine, take plums, dried apricots, figs and raisins in equal quantities, all ingredients are pre-mixed, washed and steamed with boiling water overnight. The next day, the water is drained, the seeds are removed, the pulp is ground in a meat grinder, and mixed with honey to taste. Take a tablespoon in the morning before breakfast every day.
Obstruction in children
Two forms of the disease are diagnosed: congenital and acquired. The first is a consequence of malformations of the digestive tract: pathological narrowing of the intestinal lumen, infringement of its loops, elongation of the sigmoid region.
In infants, the acute phase suddenly begins with an increase in the hardness of meconium (stool). The lumen of the hollow organ becomes clogged, the baby loses stool, and gases accumulate, which swell the tummy to a large size. The child begins to vomit, the masses coming out have yellow. It indicates the presence of bile.
Often newborns experience another specific type of obstruction - intussusception. The diagnosis is made when part of the large intestine “crawls over and swallows” the final segment of the small intestine. With this phenomenon, the baby experiences severe pain, vomits, there is no feces, instead mucus and blood are released. The anomaly is most often detected in 5–10 month old boys.
In babies under one year of age, in most cases, adhesions are diagnosed. They can develop as a result of birth injuries, past infections, immaturity of the digestive tract, after severe bruises and strip operations. In addition, kids three years mobile, constantly moving, during active games loops of the small and large intestines may become twisted.
An acute attack of adhesive nature is a complication that often leads to the death of the baby. Treat him surgically It is extremely difficult, since children have thin intestinal walls and it is difficult to sew them. Drug treatment is effective only when the disease develops due to dysfunction of the tract.
Having information about existing risks, every parent should be able to recognize the first symptoms of the described pathology:
- Severe pain, children cannot talk about it, so they cry loudly, twist, trying to take a position that reduces the intensity of the syndrome.
- Refusal to eat.
- No stool or gas.
- The occurrence of vomiting.
- Painful urge to defecate.
- Discharge from the anus is purulent or bloody.
The presence of a combination of the listed signs is a reason to call an ambulance. Without treatment, irreversible consequences are possible.
Prevention and prognosis
It is difficult to predict the results of therapy; much depends on when it was started and to what extent it was carried out. The mortality rate in the acute phase is very high. It increases in older people, with late recognized disease, and detection of inoperable tumors. When adhesions are diagnosed, relapses often occur. The patient can be cured, provided there are no inoperable cases (oncological tumors).
Prevention of the disease consists of following the principles of proper nutrition, in timely treatment and eliminating processes that can provoke it. To prevent adhesions after surgery, the patient’s recovery is carried out earlier; if there are no contraindications, physiotherapy, therapeutic exercises, and proteolytic enzymes are prescribed.
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